Are TNF Inhibitors associated with lower risk of alzheimers disease
Research type
Research Study
Full title
Are patients maintained on selective inhibitors of Tumour Necrosis Factor alpha (TNF-a), also known as biological disease-modifying anti-rheumatic drugs (b-DMARDs or "Biologics"), at a significantly lower risk of subsequently requiring treatment for Alzheimer's disease?
IRAS ID
199551
Contact name
Bernadette McGuinness
Contact email
Research summary
The occurrence of Alzheimer’s disease (AD), together with the major health and social care burden associated with it,
is predicted to increase considerably with our ageing population. Current drug treatments at best slow the
progression of the disease and only in some patients with AD. It is understood now that inflammatory processes play
a major role in the development and progression of AD. Tumour necrosis factor alpha (TNF-a), one of the key
chemical messengers mediating this inflammatory response, appears to accelerate both the changes in brain
structure and the memory problems that comprise AD. Preliminary clinical data has raised the possibility that drugs
which block the action of TNF-a may actually result in clinical improvement in AD. However the effects of these drugs,
which are already used in the treatment of rheumatoid arthritis (hence their designation as biological diseasemodifying
anti-rheumatic drugs or DMARDs), now need to be studied in larger samples. The one large UK study that
we know of identified patients with AD from death certificates, which we believe significantly underestimates the
prevalence of the disease. Our proposed study, which is funded by the Centre for Public Health at Queen’s University
Belfast, uses treatment with anti-dementia drugs as a more sensitive and specific marker of AD diagnosis, with the
aim of linking this data to registers of patients receiving biological and older, synthetic DMARDs. The study will use a
retrospective cohort design to address two research questions: whether treatment with biological DMARDs, i.e.
inhibition of TNF-a, is associated with (1) a reduction in the occurrence of AD requiring treatment and (2) an increase
in the length of time patients survive before requiring treatment for AD, compared to synthetic DMARDs which do not
block TNF-a.REC name
HSC REC B
REC reference
17/NI/0050
Date of REC Opinion
28 Feb 2017
REC opinion
Favourable Opinion